David S Davis OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

NV245 Issued in NV

Legal business name

DAVID S DAVIS OD PC

Doing business as

Vision Source

Practice address

4840 E Bonanza Rd
Suite 6
Las Vegas, NV 89110-3453

Phone

(702) 385-7331

Fax

(702) 385-5431

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Samuel Davis, ODNPI 1649276312

Title

President

Phone

(702) 385-7331

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Source Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Samuel Davis, O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1649276312
  Medicare reassignment Care Compare group NPD Authorized official
• Linda C Davis, OD

  • Optometrist
  • Las Vegas, NV
  • NPI 1477113207
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1306964382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 E BONANZA RD",
            "address_2": "SUITE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103453",
            "telephone_number": "702-385-7331",
            "fax_number": "702-385-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 E BONANZA RD",
            "address_2": "SUITE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103453",
            "telephone_number": "702-385-7331",
            "fax_number": "702-385-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S DAVIS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-385-7331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "NV245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502022",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.